Landmark heart surgery done live in SA

Heart specialists watched history being made in Cape Town as a 14-year-old boy underwent an artificial valve implant without any need to cut open his chest.

Four hundred heart specialists from around the world watched history being made in Cape Town as a 14-year-old Namibian boy underwent the implantation of an artificial valve via a vein without any need to cut open his chest.

The innovative procedure was one of many which were watched during the intervention sessions of the 6th World Congress on Paediatric Cardiology and Cardiac Surgery being held in Cape Town. Delegates were able to watch procedures which were taking place at hospitals in South Africa and Europe which were transmitted live into an auditorium.

The operation, which was hailed as a big success, was performed by South African Dr Harold Pribut and Belgian Dr Marc Gewillig.

Why the operation was performed

John Lawrenson, one of the scientific organisers of the conference explained that the boy was born with pulmonary atresia, a condition where his heart was not connected to his pulmonary arteries.

“When he was born, he was extremely blue, as there was no blood going to the lungs to pick up oxygen. He had surgery as a younger child, using a homograph. However this had become narrowed over time and started leaking. “Because the scar tissue that forms inside can sometimes defeat even the best surgeons in terms of redo operations, this homograph was replaced by a percutaneous valve.

“So a stent has been compressed, but inside this scaffolding was sewn a valve which came from a cow’s jugular vein,” Lawrenson said.

Explaining further, he said: “Cows have big veins. Inside the vein are valves. The vein has been stitched inside the stent, fitted onto a balloon and delivered into the heart. The balloon was opened up and the valve stent was placed. So the stent is now open, filling the narrowing and inside the stent is this valve that is now working.

“They have got over the narrowing and have a valve that is not leaking at all.

Lawrenson said the procedure had been done around the world for about ten years. The valve, known as the Melody Valve had become available worldwide.

“The problem is it is very expensive. Lawrenson said the Cape Town operation had gone “absolutely fine”.

A first in SA

The interventional cases had been a “remarkable” experience for delegates.

This was the first time this had been done from a conference in South Africa in terms of live paediatric cases.

“They are watching holes being closed inside the heart, they have watched narrowings in the aorta being fixed, they are watching the replacement of the aortic valve in an adult and they are going to watch the creation of a hole between chambers to allow better mixing of blood.

“We have watched interventions from Milan, Frankfurt, Cape Town and Johannesburg,” he said.

Thursday will see more local interventions when operations are transmitted from both the Red Cross Hospital and Panorama.

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